伴中央-颞区棘波儿童良性癫痫患者首次治疗分别使用丙戊酸钠、卡马西平、托吡酯的疗效比较

To Compare the Efficacy of Sodium Valproate, Carbamazepine and Topiramate in the Treatment of Benign Epilepsy with Centrotemporal Spikes in Children

目的:比较丙戊酸钠、卡马西平、托吡酯作为伴中央-颞区棘波儿童良性癫痫(benign epilepsy with centro-temporal spikes,BECT)患儿首次治疗用药的疗效。方法:回顾性选取2019年2月—2022年2月本院收治的BECT患儿100例,依据用药方法不同分为丙戊酸钠组(40例)、卡马西平组(30例)、托吡酯组(30例)。比较各组临床疗效、认知功能、生活质量、首药治疗失败时间、药物不良反应事件发生情况、家长满意度。结果:三组总有效率、操作智商、语言智商、总智商评分、生活质量评分、家长满意度比较,差异无统计学意义(P>0.05);卡马西平组首药治疗失败时间晚于丙戊酸钠组、托吡酯组(P<0.05),且丙戊酸钠组患儿的首药治疗失败时间晚于托吡酯组(P<0.05);丙戊酸钠组、卡马西平组药物不良反应事件发生率低于托吡酯组(P<0.05),但丙戊酸钠组、卡马西平组药物不良反应事件发生率比较,差异无统计学意义(P>0.05)。结论:卡马西平、丙戊酸钠、托吡酯治疗BECT的疗效相当,均能够提升患者认知功能、生活质量、家长满意度,但与托吡酯相比,丙戊酸钠、卡马西平药物作用持续时间较长、药物不良反应发生率小,可作为首选药物。

Objective: To compare the efficacy of carbamazepine, sodium valproate and topiramate in the treatment of benign epilepsy with centrotemporal spikes(BECT) in children. Methods: A total of 100 children with BECT admitted to our hospital from February 2019 to February 2022 were retrospectively selected and divided into sodium valproate group(40 cases), carbamazepine group(30 cases) and topiramate group(30 cases) according to different medication methods. The clinical efficacy, cognitive function, quality of life, failure time of first drug treatment, occurrences of adverse drug reaction events, and parental satisfaction in each group werecompared. Results: There were no significant differences in total effective rate, operational IQ, language IQ, total IQ score, quality of life score and parental satisfaction among the three groups(P>0.05).The first treatment failure time of carbamazepine group was later than that of sodium valproate group and topiramate group(P<0.05), and the first treatment failure time of children in the sodium valproate group was later than that of the topiramate group(P<0.05);The incidence of adverse drug reactions in the valproate group and carbamazepine group was lower than that in the topiramate group(P<0.05), but there was no significant difference between the valproate group and carbamazepine group(P>0.05). Conclusion: Carbamazepine, sodium valproate and topiramate have similar efficacy in the treatment of BECT, which can improve patients ’ cognitive function, quality of life and parental satisfaction. However, compared with topiramate, sodium valproate and carbamazepine have a longer duration of action and a lower incidence of adverse drug reactions, which can be used as the preferred drugs.